Constipation describes
irregular, infrequent and difficulties in bowel movements. It is a common
symptom of multiple sclerosis but is also associated
with many other conditions. It can also be a problem in otherwise healthy individuals.

Constipation is one
of those unspoken problems that can cause a lot of discomfort, embarrassment
and even pain (it drives me insane!). It can often feel like you are trying
to push out the entire bedroom wardrobe including the corners when all
you get for your efforts are a couple of rabbit droppings!

Most people with
MS have a slowed passage of food through the guts and there are a variety
of reasons for that. Officially, constipation is defined as having fewer
than two bowel movements per week or having to strain unduly more than
25% of the time, although I am wary of such rigid definitions.

In MS, constipation
can be caused by a variety of factors including slowed reflexes originating
in the brain, digestive tract or anus, spasticity
and incoordination of bowel muscles, lack of physical activity due to immobility,
depression, inadequate intake of liquids
and a diet that is low in fibre.

It's important to
take action against constipation and many of the treatments are fairly
straightforward such as increasing your intake of liquids (see below).
Excessively solid stools can impact and become so large that they can no
longer be passed out. Diaorrhea can creep around the stool and cause fecal
leakage, which, needless to say, is very embarassing. Straining too hard
can cause haemorrhoids which can itch, burn and bleed.

Fortunately, there
are a variety of simple measures you can take to alleviate constipation:

Increase your intake
of liquids. Often people with MS also have urinary problems which make
them fearful of increasing their liquid intake but this will make constipation
worse. Consult your doctor if you have this worries.

Increase your intake
of dietary fibre.

Make sure that you are
getting enough exercise. Obviously, many people with MS are rendered fairly
immobile by the condition but a degree of exercise is often possible and
exercise is also important in other ways. The MS Trust have an excellent
booklet on the subject called "Exercises for people with MS" by Liz Betts.
You can download it from this web page, http://www.mstrust.org.uk/?section=aboutms&content=newbooks

Try not to leave more
than two or three days between bowel movements.

If things get very bad,
you should consult a doctor. There are a variety of stool softeners on
the market that may help. Extended use of laxatives is generally not reccommended
because they can make matters worse in the long-term.